The $3,500 minor injury limit in Ontario: what it pays for and how the OCF-23 works

If your insurer has placed you in the Minor Injury Guideline (MIG), all of your medical and rehabilitation benefits for the accident share one limit of $3,500. Treatment usually starts through a form called the OCF-23, and a standard 12-week program under the Guideline uses a large part of that amount, so it helps to know early where the money goes.

This article is part of our series on the MIG. For the basics of who ends up in the Guideline and why, start with our main guide, Minor Injury Guideline in Ontario.

What does the $3,500 cover?

The limit comes from section 18(1) of the Statutory Accident Benefits Schedule (O. Reg. 34/10). It covers medical and rehabilitation benefits for a person whose injury is predominantly a minor injury, such as a sprain, strain, whiplash associated disorder, contusion, abrasion, laceration or subluxation.

In practice, the $3,500 pays for treatment at a clinic (physiotherapy, chiropractic care, massage therapy within the plan), the initial assessment at that clinic, some supplementary goods such as a support or exercise equipment, and x-rays in the situations the Guideline allows. Payments made under the Guideline reduce what is left of the $3,500.

Some benefits sit outside a minor injury claim entirely. Attendant care benefits under the SABS are available only when the impairment is not a minor injury, and the same applies to an in-home assessment under section 25. If your situation calls for help at home, that is usually a sign the MIG question itself deserves a closer look.

The $3,500 limit stayed the same after the July 1, 2026 reform. Medical, rehabilitation and attendant care benefits remain part of every Ontario auto policy. For a wider overview of what changed that day, see Ontario Accident Benefits changed on July 1, 2026.

Sources: O. Reg. 34/10, section 18(1), and Superintendent’s Guideline 01/14 (Minor Injury Guideline).

How the OCF-23 starts treatment

The OCF-23 is the Treatment Confirmation Form. The clinic completes it at your first visit, and a health practitioner at that clinic signs it. Under the Guideline, the practitioner submits it to your insurer within 10 business days of the initial visit, unless the insurer has waived that requirement.

Once the insurer confirms there is a valid policy, treatment listed in the OCF-23 goes ahead without separate prior approval. This is the main practical difference from the OCF-18, the treatment plan used outside the MIG, which the insurer has to review and answer.

You also sign the OCF-23 yourself, and the clinic keeps a signed paper copy on file. For many of our clients who are new to Canada, this is the first insurance form they sign in English. Take a copy home and read it in a language you are comfortable with. Check that your name, the accident date and the insurer are correct, and look at the list of injuries the clinic wrote down. The injuries recorded at this stage often come up again later if there is a dispute about whether you belong in the MIG at all.

How fast the money goes: an example

Here is an illustrative example. Olena moved to Mississauga from Kyiv a year ago. Her car was rear-ended at a red light, and her family doctor diagnosed whiplash and a shoulder strain. Her insurer placed her in the MIG, and she started treatment at a clinic near her home.

The Guideline (Superintendent’s Guideline 01/14) sets fixed fees for each stage of treatment:

If Olena completes all three blocks and the clinic bills the full supplementary amount, the program uses about $2,200 of her $3,500. Roughly $1,300 remains. If she still needs treatment after week 12, the clinic has to submit an OCF-18 for anything beyond Block 3, and that plan is paid from the same remaining amount for as long as she stays in the MIG.

Two details often surprise people. A block can be billed as monitoring at $200 instead of active treatment, but the clinic cannot bill both for the same block. If Olena changes clinics partway through, the Guideline allows a $50 transfer fee, which also comes out of the limit. Moving between clinics a few times can use up money that could have gone to treatment.

What other health coverage means now

Many people have a workplace or private health plan as well as auto insurance. Before July 1, 2026, those plans generally paid first for medical and rehabilitation costs. Since July 1, 2026, the auto insurer generally pays first for medical and rehabilitation expenses, except medication.

For someone in the MIG, this means clinic treatment is billed to the auto insurer first and draws on the $3,500 from the first visit. Prescription medication still goes to your other health plan first if you have one. Newcomers who started a job recently often have no workplace plan yet, or are still in a waiting period, so the auto policy may be the only coverage they have for physiotherapy after a crash.

If you are unsure which company should be paying in the first place, our guide on which insurer pays your Accident Benefits walks through the order.

When $3,500 looks too low for your injuries

The $3,500 limit applies only while your injury is treated as a minor injury. A person can come out of the MIG in two main ways: by showing that the injuries are more than a minor injury, or by providing compelling evidence of a pre-existing condition, documented by a health practitioner before the accident, that will prevent maximal recovery within the Guideline. Outside the MIG, a much higher limit applies to medical, rehabilitation and attendant care benefits combined.

A pre-existing condition does not take a person out of the Guideline automatically. The request to leave the MIG usually goes to the insurer on an OCF-18 with medical records attached, and if the insurer refuses, the dispute can go to the Licence Appeal Tribunal. We cover both routes in later articles in this series. If you already have a written denial, see Accident Benefits denied in Ontario? What to do next and our page on disputes at the LAT.

A few practical steps

Ask the clinic for a copy of every OCF-23 and OCF-18 submitted in your name. Keep a simple note of your visits so you can compare it with what was billed. If the remaining balance matters to you, ask your adjuster in writing how much of the $3,500 has been paid so far.

If your symptoms are not improving by the end of the second block, raise it with your family doctor. Records from your own doctor carry weight if you later need to show that your injuries go beyond the MIG.

If you would like us to look at your file, contact our team. We work in English, Russian, Ukrainian and Armenian, and we will get back to you shortly.

Frequently asked questions

VIA Legal Services Professional Corporation. Naira Velumyan is a Licensed Paralegal in Ontario (LSO #P21370). This article is for general informational purposes only and does not constitute legal advice for your specific situation.

Who handles your claim

Naira Velumyan is a Licensed Paralegal in Ontario and the founder of VIA Legal. She holds a PhD in Psychology, which shapes how she handles psychological injury claims. Read more about Naira